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目的评价聚四氟乙烯人工听骨在慢性中耳炎听力重建中的应用效果。方法回顾性分析2008年8月2009年12月慢性中耳炎手术中接受聚四氟乙烯部分/全人工听骨赝复物(Partial/Total ossicular replacementprostheses,PORP/TORP,美国美敦力公司)行听骨链重建的50例患者50只耳的临床资料及随访结果。比较听力学资料完整的39例39只耳手术前及手术后3~6个月语言频率(0.5、1.0、2.0kHz)气导平均听力及气骨导差(air-bone-cap,ABG)。结果随访3~16个月,50只耳手术后1~3个月均干耳,手术后1个月鼓膜愈合良好。9只耳手术中人工听骨表面未置入耳屏软骨,其中1只耳手术后3个月人工听骨脱出,1只耳手术后2个月鼓膜内陷,人工听骨外端盘面外突。39只耳手术前气导听力为36.67~95.00dB,平均为(59.70±14.33)dB;骨导听力为3.30~51.70dB,平均为(22.78±11.61)dB;手术后气导听力平均为(46.60±17.03)dB,与手术前比较,差异有统计学意义(P<0.01)。手术前ABG为10~60dB,平均为(37.00±12.12)dB。手术后ABG平均为(26.20±11.56)dB,与手术前比较,差异有统计学意义(P<0.01)。手术后气导听力提高10.00~30.00dB者(手术后听力提高有效)共24只耳,有效率为61.5%(24/39)。结论聚四氟乙烯人工听骨是慢性中耳炎体重建听骨的理想材料,手术后取得良好的听力结果 ,远期疗效需进一步观察。
Objective To evaluate the effect of Teflon artificial ossicles in hearing reconstruction of chronic otitis media. Methods A retrospective analysis was performed on the reconstruction of otoskeleton with partial / total ossicular replacement prostheses (PORP / TORP) from August 2008 to December 2009 in patients with chronic otitis media 50 cases of 50 patients with clinical data and follow-up results. The mean hearing-average air-bone-capillaries (ABG) were recorded at 39 frequencies of 39 ears with preoperative and 3 to 6 months postoperatively at 0.5, 1.0 and 2.0 kHz. Results The patients were followed up for 3 to 16 months. All ears were cured 1 to 3 months after operation. The tympanic membrane healed well 1 month after operation. In 9 ears, otitis media cartilage was not placed on the artificial ossicular surface. One of the ears was removed at 3 months after operation, and the tympanic membrane was retracted 2 months after operation in one ear. . The mean air-conduction hearing of 39 ears was 36.67 ~ 95.00dB, with an average of (59.70 ± 14.33) dB; the bone conduction hearing was 3.30 ~ 51.70dB with an average of (22.78 ± 11.61) dB; ± 17.03) dB, which was significantly different from that before operation (P <0.01). ABG before surgery was 10 ~ 60dB, with an average of (37.00 ± 12.12) dB. The average ABG after operation was (26.20 ± 11.56) dB, which was significantly different from that before operation (P <0.01). Postoperative airway hearing increased by 10.00 ~ 30.00dB (postoperative improvement of hearing) a total of 24 ears, the effective rate was 61.5% (24/39). CONCLUSION Teflon artificial ossicles are the ideal material for reconstruction of chronic otitis media. After the surgery, good hearing results are obtained. The long-term curative effect needs further observation.